Section I Immunology

In a Nutshell

Passive immunotherapy may be associated with several risks:

Introduction of antibodies from other species can generate IgE antibodies,

which may cause systemic anaphylaxis (see Chapter 1 3).

Passive immunotherapy can cause:

lgE production

Introduction of antibodies from other species can generate IgG or IgM anti
isotype antibodies, which form complement- activating immune complexes,
which can lead to type III hypersensitivity reactions (see Chapter 1 3 ) .

Type Ill hypersensitivity

Anti-allotype antibodies

Introduction o f antibodies from humans can elicit responses against minor

immunoglobulin polymorphisms or allotypes.

Persons with selective IgA deficiency ( 1 :700 in population, see Chapter 1 1) are at risk
to develop reactions against infused IgA (a molecule they have not seen before).

Recommended immunization schedule for persons aged 0 through 18 years - 2013.

(FOR THOSE WHO FALL BEHIND OR START LATE, SEE THE CATCH-UP SCHEDULE).

These recommendations must be read with the footnotes that follow. Forthose who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars in Figure 1. To determine minimum
intervals between doses, see the catch-up schedule (Figure 2). School entry and adolescent vaccine age groups are in bold.

Vaccines

Birth

Hepatitis B1 {HepB)
Rotavirus' (RV)
RV-1 (2-dose series); RV-5 (3-dose series)
Diphtheria, tetanus, & acellular pertussis1

I mo

2 mos

4 mos

6 mos

9 mos

t 2 mos

l S mos

j-o(-------2"dose------> [::J j""'l-l( ------------------------------3"'dose------------------- foote2

18 mos
________

1 9-23

2-3

mos

,..

yrs

4-6yrs

7-lOyrs

1 1 -12yrs

t 3 1 5 yrs

1 6-18 yrs

(DTaP:<7 yrs)

Tetanus, diphtheria, & acellular pertussis"'

{Tdap: 2.7 yrs)

Haemophi/us influenzae type b5 (Hib)

Pneumococcal conjugate (PCVl 3)

Pneumococcal polysaccharide6b.c (PPSV23)

E-1-FJ- l<E-----------

Inactivated Poliovirus7 (IPV}

rs

(< 18yea )

lnfluenza8(llV; LAIV)
2 doses for some : see footnote 8

--

, ----- ---------- -

-------------------

Annual vaccination (llV only)

1"""-------1-------->1 1
l<E------- 1"-------->l I

Measles, mumps, rubella9

(MMR)
Varicellam {VAR)
Hepatitis A11 {HepA)

,,,.._

_________

II

J
II

Ill

Annual vaccination (llV

or LAN)

Human papillomavirus12 (HPV2: females

only; HPV4: males and females)
Meningococcalu (Hib-MenCY ?: 6 weeks;
MCV4-D>9 mos; MCV4-CRM > 2 yrs.)

fl Range of recommended
L___J agesfor all children

see footnote

Ranga of recommended ages

forcatch-up immunization

13

Range of recommended ages

L____J forcertain high-risk groups

Range of recommended ages during

which catch-up is encouraged and for
certain high-risk groups

LJ

Not routinely recommended

This schedule in dudes recommendations in effect as of January 1, 2013. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a com
bination vaccine generally is preferred over separate injections of its equivalent component vaccines. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement
for detailed recommendations, available on tine at http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow vaccination should be reported to the Vaccine Adverse Event Reporting
System (VAERS) online (http://www.vaers.hhs.gov) or by telephone (800-822-7967).Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Additional information,
including precautions and contraindications for vaccination, is available from CDC on line (http://www.cdc.gov/vaccines) or by telephone (800-CDC-INFO [800-232-4636]).
This schedule is approved by the Advisory Committee on Immunization Practices (http://www.cdc.gov/vaccines/acip/index.html), the American Academy of Pediatrics (http://www.aap.org), the American Academy of
Family Physicians (http://www.aafp.org), and the American College of Obstetricians and Gynecologists {http://www.acog.org).

Figure 1-1 0-1 . Recommended Vaccination Schedule in the United States

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M E D I CA L